{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:45:42Z","timestamp":1787751942033,"version":"build-2784847793"},"reference-count":65,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2012,6,1]],"date-time":"2012-06-01T00:00:00Z","timestamp":1338508800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Dermatitis\u00ae"],"published-print":{"date-parts":[[2012,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nickel and cobalt are common causes of metal allergy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this study was to investigate nickel and cobalt exposure in belt buckles by testing 701 belts purchased in China and the United States and to consider the prevalence of nickel allergy and its relevance among Chinese patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seven hundred one belt buckles purchased in China and the United States were tested for nickel and cobalt release. Six hundred thirty-one Chinese patients with suspected allergic contact dermatitis were patch tested and interviewed to determine clinical relevance of results. The Chinese and American literature was reviewed to investigate trends in nickel prevalence over the past decades.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixty percent (n = 219) of belts purchased in China (n = 365) released nickel, and 0.5% (n = 2) released cobalt; 55.7% (n = 187) in the United States (n = 336) released nickel, and 0.9% (n = 3) released cobalt. Belt dermatitis was a significant clinical finding in 34.8% of Chinese nickel-allergic patients. Literature review suggests increasing nickel allergy prevalence in the United States and China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Metallic belt buckles are an important source of nickel exposure to consumers. Belts from lowest socioeconomic vendors were more likely to release nickel. Belts with silver color and dark metallic color were more likely to release nickel and cobalt, respectively. Clinical findings show belt dermatitis in China to be a problem.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/der.0b013e318250c354","type":"journal-article","created":{"date-parts":[[2014,4,16]],"date-time":"2014-04-16T12:05:29Z","timestamp":1397649929000},"page":"117-123","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":35,"title":["The Sino-American Belt Study: Nickel and Cobalt Exposure, Epidemiology, and Clinical Considerations"],"prefix":"10.1177","volume":"23","author":[{"given":"Dathan","family":"Hamann","sequence":"first","affiliation":[{"name":"From the *University of Arizona College of Medicine-Phoenix, Phoenix, AZ;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Hamann","sequence":"additional","affiliation":[{"name":"Loma Linda University School of Medicine, Loma Linda, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin-Feng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Peking University Third Hospital, Beijing, China;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hailian","family":"Xiang","sequence":"additional","affiliation":[{"name":"Loma Linda University School of Medicine, Loma Linda, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kylin","family":"Hamann","sequence":"additional","affiliation":[{"name":"Calvin College, Grand Rapids, MI;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard","family":"Maibach","sequence":"additional","affiliation":[{"name":"UCSF School of Medicine, San Francisco, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James S.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Cleveland Clinic, Cleveland, OH;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob P.","family":"Thyssen","sequence":"additional","affiliation":[{"name":"Department of Dermato-Allergology, Copenhagen University Hospital Gentofte, University of Copenhagen, Hellerup, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2012,6,1]]},"reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2007.01220.x"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2008.01362.x"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2010.01694.x"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.2310\/6620.2007.06060"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.2310\/6620.2009.08097"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0b013e32832d2008"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.03.017"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2008.01487.x"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.2310\/6620.2007.07013"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.0736-8046.2004.21306.x"},{"key":"e_1_3_1_12_2","first-page":"53","article-title":"Acute onset of generalized pruritic rash in a toddler","volume":"28","author":"McLean L","year":"2011","unstructured":"McLean L, , Yewchuk L, , Israel DM, et al.. Acute onset of generalized pruritic rash in a toddler. Diagnosis: systemic allergic (contact) dermatitis to nickel from ingestion of metal coins. Pediatr Dermatol, 2011; 28: 53\u201354.","journal-title":"Diagnosis: systemic allergic (contact) dermatitis to nickel from ingestion of metal coins. Pediatr Dermatol"},{"key":"e_1_3_1_13_2","first-page":"130","article-title":"Measurement of nickel, cobalt and chromium in toy make-up by atomic absorption spectroscopy","volume":"89","author":"Corazza M","year":"2009","unstructured":"Corazza M, , Baldo F, , Pagnoni A, et al.. Measurement of nickel, cobalt and chromium in toy make-up by atomic absorption spectroscopy. Acta Dermatol Venereol, 2009; 89: 130\u2013133.","journal-title":"Acta Dermatol Venereol"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.071233"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.2010.01196.x"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2010.01752.x"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2010.01866.x"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2010.01749.x"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2010.01854.x"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2005.04.077"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2007.01281.x"},{"key":"e_1_3_1_22_2","first-page":"198","article-title":"Analysis of patch test results in 116 patients with suspected allergic contact dermatitis","volume":"32","author":"MaoH","year":"1999","unstructured":"MaoH. Analysis of patch test results in 116 patients with suspected allergic contact dermatitis. Chin J Dermatol, 1999; 32: 198.","journal-title":"Chin J Dermatol"},{"key":"e_1_3_1_23_2","first-page":"1","article-title":"Analysis of patch test results in 326 patients with suspected allergic contact dermatitis","volume":"6","author":"L","year":"1999","unstructured":"L. Analysis of patch test results in 326 patients with suspected allergic contact dermatitis. Lingnan Pi Fu Bing Xue Zai Zhi, 1999; 6: 1\u20133.","journal-title":"Lingnan Pi Fu Bing Xue Zai Zhi"},{"key":"e_1_3_1_24_2","first-page":"235","article-title":"Analysis of patch test results in 380 patients with suspected allergic contact dermatitis","volume":"21","author":"Wu Hu","year":"1999","unstructured":"Wu Hu, Yu. Analysis of patch test results in 380 patients with suspected allergic contact dermatitis. Zhejiang Yi Xue, 1999; 21: 235\u2013236.","journal-title":"Zhejiang Yi Xue"},{"key":"e_1_3_1_25_2","first-page":"175","article-title":"Analysis of patch test results in 153 patients with suspected allergic contact dermatitis","volume":"28","author":"He Zeng","year":"2000","unstructured":"He Zeng. Analysis of patch test results in 153 patients with suspected allergic contact dermatitis. J Hengyang Med Coll, 2000; 28: 175\u2013176.","journal-title":"J Hengyang Med Coll"},{"key":"e_1_3_1_26_2","first-page":"441","article-title":"Analysis of patch test results in children with suspected allergic contact dermatitis","volume":"34","author":"Chen J","year":"2001","unstructured":"Chen J, , Kuang X, , Zhang J, et al.. Analysis of patch test results in children with suspected allergic contact dermatitis. Chin J Dermatol, 2001; 34: 441.","journal-title":"Chin J Dermatol"},{"key":"e_1_3_1_27_2","first-page":"99","article-title":"Analysis of patch test results in 348 patients with suspected allergic contact dermatitis in Haining, Qinhai, China","volume":"21","author":"Han J","year":"2001","unstructured":"Han J, , Zhang L. Analysis of patch test results in 348 patients with suspected allergic contact dermatitis in Haining, Qinhai, China. Chin J Microb Immuno, 2001; 21: 99\u2013100.","journal-title":"Chin J Microb Immuno"},{"key":"e_1_3_1_28_2","first-page":"122","article-title":"Analysis of patch test results in 100 patients with suspected allergic contact dermatitis","volume":"4","author":"Zhang Y","year":"2001","unstructured":"Zhang Y. Analysis of patch test results in 100 patients with suspected allergic contact dermatitis. Liaoning Yao Wu Yu Lin Chuang, 2001; 4: 122\u2013123.","journal-title":"Liaoning Yao Wu Yu Lin Chuang"},{"key":"e_1_3_1_29_2","first-page":"357","article-title":"Analysis of patch test results in 188 patients with suspected allergic contact dermatitis in Changsha, China","volume":"31","author":"Zhang G","year":"2002","unstructured":"Zhang G, , Zhou Y, , Wen H. Analysis of patch test results in 188 patients with suspected allergic contact dermatitis in Changsha, China. Chin Clin Dermatol, 2002; 31: 357.","journal-title":"Chin Clin Dermatol"},{"key":"e_1_3_1_30_2","first-page":"274","article-title":"Analysis of patch test results in 182 patients with suspected allergic contact dermatitis in Weihai, China","volume":"19","author":"Zhang R","year":"2003","unstructured":"Zhang R, , Zhang P, , Yin C. Analysis of patch test results in 182 patients with suspected allergic contact dermatitis in Weihai, China. Chin J Lepro Skin Dis, 2003; 19: 274\u2013275.","journal-title":"Chin J Lepro Skin Dis"},{"key":"e_1_3_1_31_2","first-page":"502","article-title":"Analysis of patch test results in 953 patients with suspected allergic contact dermatitis","volume":"19","author":"Wang J","year":"2003","unstructured":"Wang J, , Wang Y, , Liu J. Analysis of patch test results in 953 patients with suspected allergic contact dermatitis. Chin J Lepro Skin Dis, 2003; 19: 502.","journal-title":"Chin J Lepro Skin Dis"},{"key":"e_1_3_1_32_2","first-page":"65","article-title":"Analysis of patch test results in 235 patients with suspected allergic contact dermatitis","volume":"13","author":"Su Y","year":"2003","unstructured":"Su Y, , Li Y, , Xiao R. Analysis of patch test results in 235 patients with suspected allergic contact dermatitis. China J Mod Med, 2003; 13: 65\u201366.","journal-title":"China J Mod Med"},{"key":"e_1_3_1_33_2","first-page":"435","article-title":"Analysis of patch test results in 716 children with suspected allergic contact dermatitis","volume":"9","author":"Luo P","year":"2003","unstructured":"Luo P, , Chen J, , Zhang J. Analysis of patch test results in 716 children with suspected allergic contact dermatitis. J Mod Clin Med Bioeng, 2003; 9: 435.","journal-title":"J Mod Clin Med Bioeng"},{"key":"e_1_3_1_34_2","first-page":"545","article-title":"Analysis of patch test results in patients with suspected allergic contact dermatitis in Zhuhai, Guangdong China","volume":"20","author":"Lu D","year":"2004","unstructured":"Lu D, , Huang H, , Hu X. Analysis of patch test results in patients with suspected allergic contact dermatitis in Zhuhai, Guangdong China. Chin J Lepro Skin Dis, 2004; 20: 545\u2013546.","journal-title":"Chin J Lepro Skin Dis"},{"key":"e_1_3_1_35_2","first-page":"551","article-title":"Analysis of patch test results in 337 patients with suspected allergic contact dermatitis","volume":"27","author":"Zhou S","year":"2004","unstructured":"Zhou S, , Liu X, , Zhao Z. Analysis of patch test results in 337 patients with suspected allergic contact dermatitis. Chin J Lepro Skin Dis, 2004; 27: 551\u2013553.","journal-title":"Chin J Lepro Skin Dis"},{"key":"e_1_3_1_36_2","first-page":"633","article-title":"Analysis of patch test results in 108 patients with suspected allergic contact dermatitis","volume":"27","author":"Zhang Y","year":"2005","unstructured":"Zhang Y, , Xu T, , Zheng L. Analysis of patch test results in 108 patients with suspected allergic contact dermatitis. Beijing Yi Xue, 2005; 27: 633.","journal-title":"Beijing Yi Xue"},{"key":"e_1_3_1_37_2","first-page":"658","article-title":"Analysis of patch test results in 100 patients with suspected allergic contact dermatitis in Dalian China","volume":"21","author":"Jin L","year":"2005","unstructured":"Jin L, , Zhao Y, , Sun L. Analysis of patch test results in 100 patients with suspected allergic contact dermatitis in Dalian China. Chin J Lepro Skin Dis, 2005; 21: 658.","journal-title":"Chin J Lepro Skin Dis"},{"key":"e_1_3_1_38_2","first-page":"114","article-title":"Analysis of patch test results in 121 patients with suspected allergic contact dermatitis in Linyi, China","volume":"5","author":"Zhu X","year":"2006","unstructured":"Zhu X, , Fu S. Analysis of patch test results in 121 patients with suspected allergic contact dermatitis in Linyi, China. Chin J Dermatovenereol Integr Tradition West Med, 2006; 5: 114\u2013115.","journal-title":"Chin J Dermatovenereol Integr Tradition West Med"},{"key":"e_1_3_1_39_2","first-page":"412","article-title":"Analysis of patch test results in 530 patients with suspected allergic contact dermatitis","volume":"7","author":"Fu L","year":"2006","unstructured":"Fu L, , Xie W, , Yu M. Analysis of patch test results in 530 patients with suspected allergic contact dermatitis. China Prev Med, 2006; 7: 412\u2013414.","journal-title":"China Prev Med"},{"key":"e_1_3_1_40_2","first-page":"364","article-title":"Analysis of patch test results in 200 patients with suspected allergic contact dermatitis in Linyi, China","volume":"18","author":"Liu Y","year":"2006","unstructured":"Liu Y. Analysis of patch test results in 200 patients with suspected allergic contact dermatitis in Linyi, China. Med J Beijing Mil Reg, 2006; 18: 364.","journal-title":"Med J Beijing Mil Reg"},{"key":"e_1_3_1_41_2","first-page":"608","article-title":"Analysis of contact allergen in patients with suspected allergic contact dermatitis","volume":"20","author":"Wang D","year":"2006","unstructured":"Wang D, , Zhang W, , Yu B. Analysis of contact allergen in patients with suspected allergic contact dermatitis. Chin J Dermatovenereol, 2006; 20: 608\u2013609.","journal-title":"Chin J Dermatovenereol"},{"key":"e_1_3_1_42_2","first-page":"102","article-title":"Analysis of patch test results in 589 patients with chronic suspected allergic contact dermatitis","volume":"20","author":"Zhao L","year":"2007","unstructured":"Zhao L, , Wang L, , Hong Y. Analysis of patch test results in 589 patients with chronic suspected allergic contact dermatitis. Chin J Industrial Med, 2007; 20: 102\u2013104.","journal-title":"Chin J Industrial Med"},{"key":"e_1_3_1_43_2","first-page":"109","article-title":"Analysis of patch test results in 1129 patients with suspected allergic contact dermatitis","volume":"29","author":"Mi X","year":"2008","unstructured":"Mi X, , Ge P, , Yuan X, et al.. Analysis of patch test results in 1129 patients with suspected allergic contact dermatitis. Acad J PLA Postgrad Med Sch, 2008; 29: 109\u2013111.","journal-title":"Acad J PLA Postgrad Med Sch"},{"key":"e_1_3_1_44_2","first-page":"630","article-title":"Analysis of patch test results in 400 patients with suspected allergic contact dermatitis","volume":"8","author":"Zhang J","year":"2008","unstructured":"Zhang J, , Liu Y, , Yang R. Analysis of patch test results in 400 patients with suspected allergic contact dermatitis. Chin J Misdiagn, 2008; 8: 630\u2013631.","journal-title":"Chin J Misdiagn"},{"key":"e_1_3_1_45_2","first-page":"1456","article-title":"Analysis of contact allergen in patients with suspected allergic contact dermatitis","volume":"40","author":"Feng H","year":"2008","unstructured":"Feng H, , Hao Y, , Liu G. Analysis of contact allergen in patients with suspected allergic contact dermatitis. Inner Mongolia Med J, 2008; 40: 1456\u20131458.","journal-title":"Inner Mongolia Med J"},{"key":"e_1_3_1_46_2","first-page":"65","article-title":"Analysis of contact allergens in 300 patients with suspected allergic dermatitis","volume":"31","author":"Zhang Y","year":"2008","unstructured":"Zhang Y, , Wang X, , Gao Y. Analysis of contact allergens in 300 patients with suspected allergic dermatitis. J Bin Zhou Med Coll, 2008; 31: 65\u201366.","journal-title":"J Bin Zhou Med Coll"},{"key":"e_1_3_1_47_2","first-page":"40","article-title":"Patch testing in 462 patients with chronic suspected allergic contact dermatitis","volume":"6","author":"Wu P","year":"2009","unstructured":"Wu P, , Sun J, , Yu T. Patch testing in 462 patients with chronic suspected allergic contact dermatitis. Lab Med Clin, 2009; 6: 40\u201341.","journal-title":"Lab Med Clin"},{"key":"e_1_3_1_48_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2011.01919.x"},{"key":"e_1_3_1_49_2","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2008.23.2.315"},{"key":"e_1_3_1_50_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.1987.tb01448.x"},{"key":"e_1_3_1_51_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2010.01709.x"},{"key":"e_1_3_1_52_2","article-title":"Excessive nickel release from earrings purchased from independent shops and street markets\u2014a field study from Warsaw and London","author":"Thyssen J","year":"2010","unstructured":"Thyssen J, , Menn\u00e9 T, , Lid\u00e9n C, et al. Excessive nickel release from earrings purchased from independent shops and street markets\u2014a field study from Warsaw and London. J Eur Acad Dermatol Venereol, 2010.","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"e_1_3_1_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2009.06.034"},{"key":"e_1_3_1_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.11.893"},{"key":"e_1_3_1_55_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2009.03.030"},{"key":"e_1_3_1_56_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2010.01841.x"},{"key":"e_1_3_1_57_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2010.01812.x"},{"key":"e_1_3_1_58_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc0809293"},{"key":"e_1_3_1_59_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2008.01497.x"},{"key":"e_1_3_1_60_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2011.07.056"},{"key":"e_1_3_1_61_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2011.02001.x"},{"key":"e_1_3_1_62_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2011.01957.x"},{"key":"e_1_3_1_63_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1046-199X(00)90031-9"},{"key":"e_1_3_1_64_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.0105-1873.2005.00577.x"},{"key":"e_1_3_1_65_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2011.01957.x"},{"key":"e_1_3_1_66_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.0105-1873.2005.0592a.x"}],"container-title":["Dermatitis\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1097\/DER.0b013e318250c354","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1097\/DER.0b013e318250c354","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1097\/DER.0b013e318250c354","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T18:07:47Z","timestamp":1777399667000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.1097\/DER.0b013e318250c354"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,6,1]]},"references-count":65,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2012,6,1]]}},"alternative-id":["10.1097\/DER.0b013e318250c354"],"URL":"https:\/\/doi.org\/10.1097\/der.0b013e318250c354","relation":{},"ISSN":["1710-3568","2162-5220"],"issn-type":[{"value":"1710-3568","type":"print"},{"value":"2162-5220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,6,1]]}}}